Hippokratia
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Anemia is a prevalent situation in patients with chronic kidney disease (CKD) and can be well managed with erythropoiesis-stimulating agents (ESAs). Continuous erythropoietin receptor activator (CERA) has a long half-life that allows to be administered once monthly. The lowest recommended dose for patients with non dialysis CKD is 120 μg per month. The objectives were to assess the efficacy of subcutaneous monthly dosing of CERA in CKD stages 4 and 5 not on dialysis, and to determine the equivalent dose to epoetin β and darbepoetin α. ⋯ Monthly dosing treatment with CERA is safe and effective. A dose of 75-100 μg/month is enough to maintain stable levels of hemoglobin. Hippokratia 2014; 18 (4): 315-318.
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Neuroendocrine cell tumor in adenoma of the sigmoid is a rare neoplasm coexistence and it is considered as a mixed glandular-neuroendocrine neoplasm. ⋯ The recognition of NEC in an adenoma will help to avoid potential diagnostic pitfalls. Mixed adenoma and NEC is rare, with uncertain biological behavior. This case reinforces the view that NECs without infiltration of submucosa may have a better prognosis.
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Case Reports
Resection of endobronchial hamartoma causing recurrent hemoptysis by electrocautery and cryotherapy.
Pulmonary hamartomas are rare benign tumors of the lung with an incidence of 0.025%-0.32%. Endobronchial benign lesions can cause bronchial obstruction and recurrent respiratory infections or obstructive pneumonia and recurrent hemopthysis. ⋯ Endoscopic treatment with flexible bronchoscope, electrocautery and cryotherapy provides an excellent outcome. Surgical therapy, should be reserved for the hamartomas that cannot be approached through endoscopy. Hippokratia 2014; 18 (4): 355-356.
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Severe immune thrombocytopenia displays a rare side effect of pegylated interferon therapy for Hepatitis C infection. Our aim is to report a case of severe and late onset immune thrombocytopenia due to pegylated interferon treatment that was effectively managed with the anti-CD20 monoclonal antibody Rituximab. ⋯ Rituximab could be a valuable treatment option in pegylated interferon related immune thrombocytopenia, when patients are resistant to conventional treatment or when physicians are reluctant to administer corticosteroids.